Most Jefferson County residents would choose to be vaccinated against COVID-19, according to a survey conducted by researchers in the University of Louisville Christina Lee Brown Envirome Institute. The survey was conducted as part of the Co-Immunity Project, ongoing research to better understand the impact of COVID-19 in Jefferson County.

In February, the researchers asked adults living in Jefferson County their perceptions about the coronavirus vaccine in order to identify potential barriers to vaccine uptake and to better understand vaccine hesitancy. Letters were mailed to 35,999 households across all geographic sectors of the county inviting the recipients to take part in the survey as well as to make an appointment for free testing for COVID-19, also part of the Co-Immunity Project.

“We wanted to better understand which residents had access to the vaccine as well as their attitudes toward the vaccine,” said Aruni Bhatnagar, Ph.D., director of the UofL Brown Envirome Institute. “This information would help us improve equity in vaccine availability as well as help us understand the reasons behind vaccine hesitancy in our community. So, we incorporated the survey opportunity into our outreach for random community testing for the virus.”

The survey included questions about whether the person had been vaccinated, where they received most of their information about the vaccine and where they would prefer to be vaccinated. They also had an option to indicate they would not get vaccinated. They also were asked what would make them more likely to be vaccinated and what influenced those who were hesitant to vaccination.

Participants completed the questionnaire on a website that also offered them the opportunity to schedule an appointment for COVID-19 infection and antibody testing. Most of the 1,296 survey participants were age 60 or over (44%), female (61%) and white (84%) and 90.2% reported being unvaccinated.

An overwhelming majority of participants (91%) indicated they would choose to be vaccinated, with slightly lower rates among minority participants. Vaccine-hesitant participants suggested that more evidence of safety and effectiveness or their health provider’s recommendation would increase their likelihood of getting vaccinated. Although vaccines are provided for free, concerns about cost were seen in more than half the participants.

While most vaccine-hesitant participants expressed concern about side effects and safety, followed by not “tested on enough people who are like me,” minority participants expressed these concerns at higher rates and many vaccine participants from all races had concerns about the timeline of vaccine development. Other concerns were related to the efficacy of the vaccines, vaccines in general and government mistrust.

About 3% of white and 8% of minority participants indicated they would never choose vaccination. Minority participants reported they were more likely to choose vaccination with celebrity endorsement, offerings by faith organizations and vaccination requirements. White participants were more likely to choose vaccination if their family and friends or elected officials were vaccinated and with evidence of efficacy.

Most participants would prefer to be vaccinated by their health care provider, followed by a mobile or walk-in clinic, a pharmacy or a hospital. Other sites, such as community organizations, community recreation centers, workplaces or schools were of interest to one-fourth or less of participants. Minority participants were less interested in vaccination at work, pharmacies, libraries and mobile or walk-up clinics and more interested in being vaccinated at food distribution centers or by their health care provider.

Compared with white participants, minority participants were less likely to report knowing how to find out their vaccine eligibility or sign up for a vaccination.

While they acknowledge limitations to the study due to the fact that it was delivered along with the testing invitation and that it required a computer and internet access to complete, the researchers believe analysis of the results will be helpful in increasing access and acceptance of vaccines among different populations.

“Obtaining information on how to get a vaccine continues to be burdensome and solutions to this problem will help with more equitable vaccine distribution,” said Rachel Keith, Ph.D., assistant professor in the UofL Department of Medicine and a lead investigator in the Co-Immunity Project.